Background typhoid fever is the commonest cause of non traumatic terminal ileal perforation in our study with a grave postoperative morbidity & mortality depending upon preoperative time delay &/or type of surgical intervention practiced.
Objective to evaluate the frequency of non traumatic causes of terminal ileal perforation, their presentations,perforation-operation interval effect on complications, as well as different modalities of treatment and their complications.
Methods the study is a prospective study of 82 patients with perforation of terminal ileum diagnosed by explorative laparatomy in Al Kindy teaching hospital ,Baghdad, Iraq from April 2008- December 2010, all of the patients were examined clinically & investigated by plain x-ray of abdomen, ultrasound, complete blood picture, laparatomy was done for them after resuscitation and intravenous antibiotic, tissue biopsy was taken for paraffin section histopathological examination, and patients were followed for complications.
Results: the study of 82 patients revealed that their mean age 42 years (±14) ranging from16-75 years, with male to female ratio is 2, 28:1. The main cause of perforation is enteric fever 59 (71.95%) of patient, non specific inflammation 17(20.74%), Chronic granulomatous lesion 5(6.1%). The main presenting symptom in all patients was severe abdominal pain associated with fever, and abdominal distention in variable degree.The operative finding was single perforation in 61patients(74%) , two perforations in 8 patients(10%) and multiple in 13 patients(16%). The simple closure was done in 50 patients(60%), and other treated by resection and end to end anastomosis , Loop ileostomy,Resection and ileotransverse anastomosis, and follow up of patients revealed that 7(8%) died postoperatively , 3 patients(3.6%) developed wound dehiscence,6 patients(7%) developed enterocutanous fistula ,10 patients (12.1%) developed wound infection and 6 patients (7.3%) developed residual collection.
Conclusion non-traumatic perforation of terminal ileum is not uncommon and the most common cause is typhoid fever, and carries high mortality and morbidity rates specially in delayed presentation & diagnosis group of patients.
“Child of today is a man of the future" this slogan is one of the most popular logos of international organizations and institutions that dealing with human beings needs in general and children needs in particular, whether these needs are educational, health, social, or economic. Children require special care and extra legal protection, since the child-raising is not the Child’s own issue, but it's the issue of the society in which he/she would integrate.
As the education and language skillsacquisition primarily associated with hearing, because human being receives most of the skills and knowledge through the hearing; that imitate sounds and learn how to speak isacquired only by hearing, so therefore the hearing - impairedchi
... Show MoreThe preparation and characterization of innovative nanocomposites based on zinc oxide nanorods (ZNR) encapsulated by graphene (Gr) nanosheets and decorated with silver (Ag), and cupper (Cu) nanoparticles (NP) were studied. The prepared nanocomposites (ZNR@Gr/Cu-Ag) were examined by different techniques including Field Emission Scanning Electron Microscope (FESEM), Transmission electron microscopy (TEM), Atomic force microscopy (AFM), UV-Vis spectrophotometer and fluorescence spectroscopy. The results showed that the ZNR has been good cover by five layers of graphene and decorated with Ag and Cu NPs with particles size of about 10-15 nm. The ZNR@Gr/Cu-Ag nanocomposites exhibit high absorption behavior in ultraviolet (UV) region of sp
... Show MoreThe biggest problem of structural materials for fusion reactor is the damage caused by the fusion product neutrons to the structural material. If this problem is overcomed, an important milestone will be left behind in fusion energy. One of the important problems of the structural material is that nuclei forming the structural material interacting with fusion neutrons are transmuted to stable or radioactive nuclei via (n, x) (x; alpha, proton, gamma etc.) reactions. In particular, the concentration of helium gas in the structural material increases through deuteron- tritium (D-T) and (n, α) reactions, and this increase significantly changes the microstructure and the properties of the structural materials. T
... Show MoreBiodiesel can be prepared from various types of vegetable oils or animal fats with the aid of a catalyst.
Calcium oxide (CaO) is one of the prospective heterogeneous catalysts for biodiesel synthesis. Modification
of CaO by impregnation on silica (SiO2) can improve the performance of CaO as catalyst. Egg shells and rice
husks as biomass waste can be used as raw materials for the preparation of the silica modified CaO catalyst.
The present study was directed to synthesize and characterize CaO impregnated SiO2 catalyst from biomass
waste and apply it as catalyst in biodiesel synthesis. The catalyst was synthesized by wet impregnation
method and characterized by x-ray diffraction, x-ray fluorescence, nitr
Hydrogen productions were achieved by irradiating ethanol ic aqueous solutions (20%. v/v) containing mixtures of the ligand 2,4- dimethoxybcnzylidene-2-hydroxy aniline (HL) or one of i ts complexes (ML2) wi th the following divalent ions: fVbl (II), Fc(IT), Co(II). Ni( rt ), Cu(H) and Zn (11), as photosensi1izers, methyl viol ogen (MY.:-) as electron acceptor. ethylene diamine  
... Show MoreThe widespread use of the Internet of things (IoT) in different aspects of an individual’s life like banking, wireless intelligent devices and smartphones has led to new security and performance challenges under restricted resources. The Elliptic Curve Digital Signature Algorithm (ECDSA) is the most suitable choice for the environments due to the smaller size of the encryption key and changeable security related parameters. However, major performance metrics such as area, power, latency and throughput are still customisable and based on the design requirements of the device.
The present paper puts forward an enhancement for the throughput performance metric by p
... Show MoreThe research explored the impact of applying lean thinking With all that carries this term of goals, trends, principles, foundations and concepts, The possibility of applying it in institutions, including Ur public company, an industrial company, And the only one in Iraq specialized in the manufacture of cables, Electrical Wires and the aluminum industry ,Which has been applied to the curriculum of lean thinking , The problem of research is that the institutions, including the company (research sample), adopt and practice traditional administrative, financial and technical methods without relying on modern curricula and ideas, including the subject of our research, In order to achieve the research objectives, the research was divided int
... Show MoreIn this study Microwave and conventional methods have been used to extract and estimate pectin and its degree of esterification from dried grapefruit and orange peels. Acidified solution water with nitric acid in pH (1.5) was used. In conventional method, different temperature degrees for extraction pectin from grape fruit and orange(85 ,90 , 95 and 100?C) for 1 h were used The results showed grapefruit peels contained 12.82, 17.05, 18.47, 15.89% respectively, while the corresponding values were 5.96, 6.74, 7.41 and 8.00 %, respectively in orange peels. In microwave method, times were 90, 100, 110 and 120 seconds. Grapefruit peels contain 13.86, 16.57, 18.69, and 17.87%, respectively, while the corresponding values were of 6.53, 6.68, 7.2
... Show MoreThe ligand 2-[1-(1H-indol-3-yl)ethylimino) methyl]naphthalene-1-ol, derived from 1-hydroxy-2-naphthaldehyde and 2-(1H-indol-3-yl)ethylamine, was used to produce a new sequence of metal ions complexes. Thus ligand reactions with NiCl2.6H2O, PdCl2, FeCl3.6H2O and H2PtCl6.6H2O were sequentially made to collect mono-nuclear Ni(II), Pd(II), Fe (III), and Pt(IV). (IR or FTIR), Ultraviolet Reflective (UV–visible), Mass Spectra analysis, Bohr-magnetic (B.M.), metal content, chloride content and molar conductivity have been the defining features of the composites. The Fe(III) and Pt(IV) complexes have octahedral geometries, while the Ni(II) complex has tetra
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